| NPI | 1366654675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH ROYCE HAWKINS Partner 580-353-4113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: OK 3-5058) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK 3-5058) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2015-08-03 |